Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Effectiveness of Acute Malnutrition Treatment at Health Center and Community Level with a Simplified, Combined Protocol in Mali: An Observational Cohort Study

Suvi T. Kangas
* ORCID logo ,
Bethany Marron
,
Zachary Tausanovitch
,
Elizabeth Radin
,
Josiane Andrianarisoa
,
Salimou Dembele
,
Issa Niamanto Coulibaly
,
Cesaire Ouedraogo
,
Marie Biotteau
,
Bareye Ouologuem
,
Soumaila Daou
,
Fatoumata Traore
,
Issiaka Traore
,
Marc Nene
,
Jeanette Bailey
Version 1 : Received: 5 September 2022 / Approved: 7 September 2022 / Online: 7 September 2022 (05:21:16 CEST)

A peer-reviewed article of this Preprint also exists.

Kangas, S.T.; Marron, B.; Tausanovitch, Z.; Radin, E.; Andrianarisoa, J.; Dembele, S.; Ouédraogo, C.T.; Coulibaly, I.N.; Biotteau, M.; Ouologuem, B.; Daou, S.; Traoré, F.; Traoré, I.; Nene, M.; Bailey, J. Effectiveness of Acute Malnutrition Treatment at Health Center and Community Levels with a Simplified, Combined Protocol in Mali: An Observational Cohort Study. Nutrients 2022, 14, 4923. Kangas, S.T.; Marron, B.; Tausanovitch, Z.; Radin, E.; Andrianarisoa, J.; Dembele, S.; Ouédraogo, C.T.; Coulibaly, I.N.; Biotteau, M.; Ouologuem, B.; Daou, S.; Traoré, F.; Traoré, I.; Nene, M.; Bailey, J. Effectiveness of Acute Malnutrition Treatment at Health Center and Community Levels with a Simplified, Combined Protocol in Mali: An Observational Cohort Study. Nutrients 2022, 14, 4923.

Abstract

The simplified, combined protocol admits children with a mid-upper-arm circumference (MUAC) of <125 mm or edema to malnutrition treatment with ready-to-use therapeutic food (RUTF) prescribing 2 daily RUTF sachets to children with MUAC <115 mm or edema and 1 daily sachet to those with MUAC ≥115 mm but <125 mm. This treatment has previously been shown to result in non-inferior programmatic outcomes compared to standard treatment. We aimed at observing its effectiveness in a routine setting at scale, including via delivery by community health workers (CHW). A total of 27 601 children were admitted to the simplified, combined treatment. Treatment resulted in 96% overall recovery with a mean LOS of 40 days and a mean RUTF consumption of 63 sachets per child treated. Among children admitted with MUAC <115 mm or edema 94% recovered with a mean LOS of 55 days and consuming an average of 97 RUTF sachets. Recovery in all sub-groups studied exceeded 90%.Treatment by CHWs resulted in similar (96%) recovery as treatment by formal health care workers (96%). The simplified, combined protocol results in high recovery and low RUTF consumption per child treated, and can safely be adopted by CHWs to provide treatment in the community-level.

Keywords

acute malnutrition; combined protocol; community-based management of acute malnutrition; ef-fectiveness; Mali; mid-upper-arm circumference; moderate acute malnutrition; ready-to-use ther-apeutic food; treatment; severe acute malnutrition; simplified protocol; wasting

Subject

Medicine and Pharmacology, Dietetics and Nutrition

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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